The Suginami Tragedy: Tokyo's Horrific Child Murders

On the morning of May 25, 1938, a Tokyo police officer entered a small house in the Suginami district and was hit by a smell so overpowering he later said it felt “as if the air itself was rotting.” Inside, he found five young children—brothers and sisters—all dead, laid out side by side on futons, their faces peaceful, as if sleeping. There was a handwritten note on the table, pinned under a cup of tea that had long since gone cold.

The woman responsible for the crime, Miyuki Ishikawa, stood waiting in the next room. She had not run, had not hidden. The only sound in the house was the ticking of a wall clock, counting off the final moments of a crime that would shock Japan, reveal hidden horrors, and push the country to question its most sacred institutions.

Miyuki Ishikawa was born in 1897 in rural Kōchi Prefecture, on the island of Shikoku. Her childhood was typical for the era: strict, impoverished, and shadowed by the heavy expectations placed on girls in the early 20th-century Japanese countryside. At the age of 16, she moved to Tokyo to study midwifery at a time when the city's population was exploding—rising from 2 million in 1920 to nearly 6 million by 1940, making it one of the biggest urban shifts in the world at that time.

Ishikawa graduated from a government-run midwifery school in 1919, one of only a few dozen women in her class. She quickly made a name for herself as an efficient, reliable midwife. By the mid-1930s, she had been appointed the director of the Kotobuki Maternity Hospital, a small private facility in Suginami ward, then a growing suburb on Tokyo’s fringe.

Her husband, Takeo Ishikawa, was a clerk who worked irregular hours. The couple had no children of their own. Neighbors described Miyuki as polite but distant, always in starched white uniforms, rarely seen smiling. Those who worked at the hospital remembered her as a strict disciplinarian, obsessed with cleanliness and order.

The Kotobuki Maternity Hospital was typical for its time—eight rooms, with room for about 40 mothers and infants. It catered mostly to poor, unmarried women, many of whom had traveled to Tokyo from the countryside to work as maids or factory laborers. In late 1937, at the height of Japan’s imperial expansion in East Asia, the city’s birth rate climbed sharply, as did the number of families unable or unwilling to care for new infants.

The hospital began offering to “help” mothers unable to raise their children. This help was never officially recorded, nor did it appear in hospital brochures. Instead, it was exchanged in whispered conversations between Miyuki Ishikawa and desperate mothers, usually late at night, out of earshot of hospital staff.

The arrangement was simple and brutal. The mother would sign a statement “relinquishing” her child. In some cases, she paid a small fee. Miyuki promised the child would be placed with a childless couple or sent to an orphanage. In reality, the infants were either neglected to the point of death or killed outright, their bodies quietly disposed of by hospital staff.

Between late 1937 and the spring of 1938, Ishikawa and at least two accomplices—her husband, Takeo, and a hospital maintenance worker named Shiro Nakayama—carried out what is believed to be Japan’s deadliest serial killing by a woman, and one of the worst cases of organized infanticide in East Asian history.

The killings followed a pattern. Newborns deemed “unwanted” were isolated in a back room, often denied milk, warmth, and basic care. Sometimes, death came within days. Other times, infants lingered for weeks in misery. Ishikawa kept a logbook, recording names, dates, and the payments made by desperate mothers or—less often—by fathers who wanted the secret kept.

By March 1938, local hospitals noticed a spike in infant deaths, but most assumed it was due to the ongoing economic crisis and worsening food shortages. Japan’s rapid militarization had drained resources from civilian life, and infant mortality rates in Tokyo were already among the highest in the developed world, at nearly 120 deaths per 1,000 live births in some wards.

On the night of May 24, 1938, a neighbor saw Ishikawa wheel a covered laundry cart from the back entrance of the hospital. The cart, she would later tell police, “reeked of something foul.” The neighbor thought little of it at the time; hospitals in Tokyo often disposed of medical waste in secret, especially with wartime rationing making formal disposal expensive.

Just before dawn on May 25, police were called to the Kotobuki Maternity Hospital by a junior nurse who had grown suspicious. She claimed that Ishikawa had ordered her to ignore the cries of a newborn, and that she had seen Ishikawa inject something into the child’s milk bottle. The nurse, terrified, waited until Ishikawa left the ward, then called the Suginami police station.

The officer who arrived found the scene as described: five dead infants, all less than two months old, their bodies arranged on futons. The note on the table, written in careful calligraphy, read: “I have relieved these children of their suffering. May the gods forgive me for what I have done.” Ishikawa was taken into custody without protest. She reportedly told the officer, “You will find more.”

In the days that followed, police, led by Inspector Tadao Sato, launched a sweeping investigation. Sato was a veteran of the Tokyo Metropolitan Police, with a reputation for diligence and a deep skepticism of hospital authorities. He ordered the hospital closed and began a room-by-room search.

In a locked cabinet, police found a ledger with the names of 47 infants, dates of birth, and modest payments listed beside each entry. Cross-referencing hospital admissions with municipal birth records, they quickly identified at least 40 infants who had disappeared under Ishikawa’s care between November 1937 and May 1938.

When questioned, Ishikawa claimed she was “helping” unwanted children escape a lifetime of hardship. She insisted that the mothers, often unmarried and destitute, had begged her to take their babies. She described herself as “merciful,” arguing that she spared both the children and their mothers from disgrace and poverty. Police found no evidence that any child had ever been placed with another family or orphanage.

Searches of the hospital grounds and nearby river yielded the remains of at least 15 infants, most in advanced stages of decomposition. Forensic analysis, crude by modern standards, suggested death by starvation and neglect, with no evidence of direct violence in most cases. In two cases, traces of morphine were found in the infants’ stomachs.

Ishikawa’s husband, Takeo, was arrested after police discovered he had forged documents for several mothers, helping them evade notice by city authorities. Shiro Nakayama, the hospital maintenance worker, confessed to transporting bodies and discarding them in the Tamagawa River, which runs through western Tokyo.

The investigation was hampered by the lack of central record-keeping. In prewar Tokyo, births and deaths among the poor were rarely reported. Many mothers who surrendered their children to Ishikawa could not be located, having left the city to escape shame or find work elsewhere.

When the case went to trial in the autumn of 1938, it drew massive crowds to the Tokyo District Court. Local newspapers dubbed Ishikawa “The Demon Midwife,” and public outrage was immediate. The prosecution, led by Kenjiro Tanaka, charged Ishikawa and her two main accomplices with multiple counts of murder, illegal disposal of bodies, and fraud. The judge, Matsuo Nishi, was known for his severe rulings in cases involving public morality.

The most damning evidence came from Ishikawa’s own logbook. The prosecution presented each entry, with dates and payments, to establish the pattern and scale of the killings. Witnesses included the surviving hospital staff, who described a climate of fear and intimidation, with Ishikawa threatening to “ruin” anyone who questioned her actions.

The defense argued that Ishikawa had acted under societal pressure, pointing to the impossibility for unmarried women to raise children in 1930s Japan. They claimed that the Japanese social welfare system, almost non-existent at the time, forced both the mothers and Ishikawa into desperate measures.

In December 1938, the Tokyo District Court convicted Miyuki Ishikawa, her husband Takeo, and Shiro Nakayama of multiple counts of manslaughter and illegal disposal of corpses. Miyuki Ishikawa was sentenced to eight years in prison, a sentence many in Japan considered shockingly light given the scale of the crimes.

The verdict was controversial even then. The judge ruled that “society itself” was partly to blame, citing the lack of support for unwed mothers and the overwhelming poverty of the period. The sentence was later reduced on appeal, and Ishikawa was released after serving only a handful of years. Her fate after prison remains unknown; some reports suggest she changed her name and lived quietly in rural Japan.

The Kotobuki Maternity Hospital was closed permanently. The building stood abandoned for several years before being demolished in the early 1950s as Tokyo rebuilt after World War II.

The case triggered public debate about the status of women, children, and the poor in Japanese society. Newspapers published editorials calling for the government to reform adoption laws and improve maternal care. For the first time, the Japanese parliament debated the creation of a modern child welfare system. In 1947, Japan passed the Child Welfare Law, aimed at protecting children and supporting single mothers.

The investigation revealed deep flaws in Japan’s social safety net. Before the Child Welfare Law, the country had fewer than 10 public orphanages in its largest city—less than one per 500,000 people—and almost all were chronically underfunded. This meant that hospitals like Kotobuki became the last recourse for the most desperate mothers.

The crime exposed the vulnerability of infants in a rapidly modernizing society. In Tokyo in the late 1930s, as many as 1 in 8 children born to unmarried women did not survive their first year, according to city records from that decade.

The case also showed how crime could flourish in the gaps between traditional values and modern reality. The stigma attached to illegitimacy was so severe that some families would disown daughters who became pregnant before marriage. Abortion was illegal and dangerous, while adoption was largely restricted to male heirs, making it nearly impossible for unwanted babies to find new families.

The Ishikawa case became required reading in Japanese police academies in the 1950s, cited as an example of how social neglect can foster crime. The case also features in Japanese legal textbooks as a turning point in the nation’s approach to child protection and welfare.

The public’s reaction was immediate and overwhelming. Within weeks of the verdict, women’s groups organized protests in Tokyo, demanding better hospital oversight and support for single mothers. Petition drives for new adoption laws gathered thousands of signatures in a matter of days.

The case is still sometimes referenced in Japanese debates about welfare, abortion, and the responsibility of health care providers. The scale of the crime is surpassed only by its chilling method—murder by systematic neglect, with the victims erased both from family records and official statistics.

The logbook kept by Miyuki Ishikawa survives as evidence, now held in the archives of the Tokyo Metropolitan Police. It lists names, dates, and short notations—some as brief as “No milk, mother gone,” others as cold as “Paid 3 yen. Disposed next day.” The total number of victims is unknown, but police believe more than 100 infants may have died at Kotobuki Hospital.

In a city of millions, the cries of the smallest and most vulnerable can still be lost. In 1938, the silence of the Kotobuki Maternity Hospital was broken only when a nurse, unable to bear it any longer, dialed the police, changing the course of Japanese criminal justice forever.